Abstract
BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are one of the most significant problems among nurses worldwide. No meta-analysis of overall and body-area prevalence of WMSDs has been conducted among nurses from one continent to another. AIM: The aim of this meta-analysis and meta-regression was therefore to assess in depth the prevalence of work-related musculoskeletal disorders among nurses by continent. METHODS: The systematic review was performed in accordance with PRISMA guidelines. Five databases, i.e. ScienceDirect, PubMed/Medline, Google Scholar, Science.gov and Mendeley, were scanned to identify relevant studies. Study selection, critical appraisal and data extraction were carried out independently by the two authors. Cochran's Q test and the I(2) statistic were used to assess study heterogeneity. A meta-regression analysis was performed to investigate the impact of nurses' age, professional experience, body mass index and year of study publication on WMSD prevalence. RESULTS: Among the 15,751 unique items identified, 71 studies published between 2002 and 2024 met the inclusion/exclusion criteria and were included in the analysis, totaling 33,809 nurses. Lower back was the most exposed area (58.0%; CI 95%: 54.2%-61.8%). Europe ranked first (61.3%), followed by America (59.3%), Asia (58.4%) and Africa (58.0%). Neck (44.9%; CI 95%: 40.1%-49.8%) and shoulder (40.9%; CI 95%: 54.2%-61.8%) were also highly affected. Europe was the continent most affected for neck, upper back, lower back and wrist, America the most for shoulderwhile Asia ranked first for lower limb body areas. Africa was the continent least exposed to WMSDs. Eight significant correlations were found between: nurses' age and shoulder prevalence in Africa, year of publication and neck prevalence in Asia. The following six were for Europe: nurses' age and experience on wrist prevalence, and year of publication on shoulder, elbow, wrist and hip prevalence. CONCLUSIONS: The meta-analysis showed the most exposed areas and meta-regression between three demographic parameters, the prevalence of WMSD by body area per continent. The development of ergonomic programs, organizational work strategies and assistive devices must be pursued to prevent WMSDs in nurses, in order to reduce their effects and improve the nurses' quality of life at work. CLINICAL TRIAL NUMBER: Not applicable.